Exercise Cardio-Oncology: Exercise as a Potential Therapeutic Modality in the Management of Anthracycline-Induced Cardiotoxicity

Anthracyclines are one of the most effective chemotherapy agents and have revolutionized cancer therapy. However, anthracyclines can induce cardiac injuries through ‘multiple-hits', a series of cardiovascular insults coupled with lifestyle risk factors, which increase the risk of developing short- and long-term cardiac dysfunction and cardiovascular disease that potentially lead to premature mortality following cancer remission. Therefore, the management of anthracycline-induced cardiotoxicity is a serious unmet clinical need. Exercise therapy, as a non-pharmacological intervention, stimulates numerous biochemical and physiologic adaptations, including cardioprotective effects, through the cardiovascular system and cardiac muscles, where exercise has been proposed to be an effective clinical approach that can protect or reverse the cardiotoxicity from anthracyclines. Many preclinical and clinical trials demonstrate the potential impacts of exercise on cardiotoxicity; however, the underlying mechanisms as well as how to implement exercise in clinical settings to improve or protect against long-term cardiovascular disease outcomes are not clearly defined. In this review, we summarize the current evidence in the field of “exercise cardio-oncology” and emphasize the utilization of exercise to prevent and manage anthracycline-induced cardiotoxicities across high-risk and vulnerable populations diagnosed with cancer.

Cathepsin S as an early biomarker for cardiovascular disease in chronic kidney disease patients

Introduction: A high incidence of cardiovascular disease (CVD) events and premature mortality is observed in patients with chronic kidney disease (CKD). Thus, new biomarkers that may help predict the development of CVD in early stages of CKD are being investigated along with other traditional risk factors. Objective: To investigate cathepsin S as an early biomarker for CVD in patients with CKD. Methods: A total of 64 patients with CKD were included and classified into 2 groups: CKD patients with established CVD and CKD patients with non-established CVD. All patients were submitted to routine investigations including complete blood count, random blood sugar, glycated hemoglobin (HbA1c), serum electrolytes, urea, creatinine, total protein, total albumin, calcium total, phosphorous, uric acid, vitamin D, parathormone, lipid profile, liver function test, measurement of serum cathepsin S (Cat S), and 2D Echo of the heart. Results: The level of serum Cat S was increased in CKD patients with CVD (p <0.05) as well as in later stages of CKD (p <0.05). CVD was also more common in patients in early stage CKD. In early stages CKD, Cat S and CVD were positively correlated. Conclusion: These findings suggest that serum Cat S might be useful as an early biomarker for CVD in CKD patients.

Premature mortality attributable to COVID-19: potential years of life lost in 17 countries around the world, January–August 2020

Background Understanding the impact of the burden of COVID-19 is key to successfully navigating the COVID-19 pandemic. As part of a larger investigation on COVID-19 mortality impact, this study aims to estimate the Potential Years of Life Lost (PYLL) in 17 countries and territories across the world (Australia, Brazil, Cape Verde, Colombia, Cyprus, France, Georgia, Israel, Kazakhstan, Peru, Norway, England & Wales, Scotland, Slovenia, Sweden, Ukraine, and the United States [USA]). Methods Age- and sex-specific COVID-19 death numbers from primary national sources were collected by an international research consortium. The study period was established based on the availability of data from the inception of the pandemic to the end of August 2020. The PYLL for each country were computed using 80 years as the maximum life expectancy. Results As of August 2020, 442,677 (range: 18–185,083) deaths attributed to COVID-19 were recorded in 17 countries which translated to 4,210,654 (range: 112–1,554,225) PYLL. The average PYLL per death was 8.7 years, with substantial variation ranging from 2.7 years in Australia to 19.3 PYLL in Ukraine. North and South American countries as well as England & Wales, Scotland and Sweden experienced the highest PYLL per 100,000 population; whereas Australia, Slovenia and Georgia experienced the lowest. Overall, males experienced higher PYLL rate and higher PYLL per death than females. In most countries, most of the PYLL were observed for people aged over 60 or 65 years, irrespective of sex. Yet, Brazil, Cape Verde, Colombia, Israel, Peru, Scotland, Ukraine, and the USA concentrated most PYLL in younger age groups. Conclusions Our results highlight the role of PYLL as a tool to understand the impact of COVID-19 on demographic groups within and across countries, guiding preventive measures to protect these groups under the ongoing pandemic. Continuous monitoring of PYLL is therefore needed to better understand the burden of COVID-19 in terms of premature mortality.

PM10 Alters Trophoblast Cell Function and Modulates miR-125b-5p Expression

Air pollution is one of the largest global environmental health hazards that threaten premature mortality or morbidity. Particulate matter 10 (PM10) has been demonstrated to contribute to several human diseases via dysregulated miRNA expression. Trophoblast cells play a key role in implantation and placentation for a successful pregnancy. Nonetheless, the PM10 associated trophoblast cell functions during pregnancy and miRNA expression are still unknown. Our study showed that PM10 affected HTR-8/SVneo cell viability and also decreased cell proliferation, migration, and invasion. A high concentration of PM10 caused an increase in HTR-8/SVneo cell apoptosis. Treatment with PM10 induced inflammation through the upregulated IL-1β, IL-6, and TNF-α expression in trophoblast cells. In PM10-treated HTR-8/SVneo cells, miR-125b-5p expression was considerably increased and TXNRD1 was found to be negatively related to miR-125b-5p. Collectively, our findings revealed that PM10 could alter miR-125b-5p expression by targeting TXNRD1 and suppressing trophoblast cell functions. Additional investigations relating to the function of miR-125b-5p and its target on particulate pollution exposure in trophoblast are warranted for future biomarker or effective therapeutic approaches.

Monitoring and assessment of fire consequences in the Republic of Buryatia

The article aims to study statistical data on the consequences of fires in the Republic of Buryatia from 2009 to 2020 using the methods of social and mathematical statistics. The study is relevant due to the current situation with fires and integral fire risk indicators in the municipalities. Man-made fires have been a source of increased danger to health and lives of the population, causing great material damage. Fires are a direct threat to the demographic situation in the region since they cause premature mortality. For households, fires undermine social status, destroy social units, cause moral harm aggravating stress, which provokes illnesses. From the technical point of view, man-made fires create risks for dilapidated houses and facilities that do not meet the fire safety requirements. The Republic of Buryatia is a region with a weak degree of industrial development and a vast territory with a low distribution of settlements, i.e. considerable remoteness from the regional centers. The impact of fires (which make up 99% of all types of emergency situation) on the social well-being of the population is studied. Based on the methodology and calculations of fire risks by the number of fires, injured and killed, material damage and destroyed buildings, it was established that the level of protection of residents of Buryatia from fire risks is insufficient. The indicators should encourage the government to develop and implement effective safety measures.

Risk of Injury to Others: The Development of an Algorithm to Identify Children and Youth at High-Risk of Aggressive Behaviours

Youth violence is considered one of the most preventable causes of morbidity and premature mortality. Various risk factors have previously been identified, however, there is presently a crucial need to develop effective decision-support tools in order to identify children and youth at increased risk for violence. The current study utilised data collected from the interRAI Child and Youth Mental Health Screener (ChYMH-S), within the province of Ontario, to develop and validate a methodology for the purpose of identifying young persons who were at greater risk of harm to others. Additional data from 59 mental health agencies validated the algorithm, and it was found to be a strong predictor of harmful behaviour toward others. The RIO algorithm provides a valuable decision-support tool with strong psychometric properties that may be used to identify young persons who exhibit signs or symptoms associated with increased likelihood of harm toward others, in order to provide early intervention efforts for these vulnerable youth, thereby reducing the likelihood of future aggressive behaviours.

Exposure to ambient gaseous air pollutants and adult lung function: a systematic review

Exposure to hazardous air pollutants is identified as most obvious premature mortality factors in the world. Numerous epidemiological studies have estimated exposure to air pollutants may cause pulmonary toxicity and the incidence of respiratory diseases including chronic obstructive pulmonary disease (COPD), chronic bronchitis and asthma. The currently research was performed to evaluation the association between gaseous pollutants and lung function in healthy adults. Articles related to this study were selected from researches of Scopus, PubMed, and Web of Science databases. A total of 2,644 articles were retrieved and 39 records were reviewed after removing duplicates and excluding irrelevant studies. The result of this systematic review indicated that there is some evidence on decreasing lung function with exposure to gaseous air pollutants (NO2, SO2, and O3) which can have negative effects on human health. Although according to the evidence changes in lung function are mostly linked to the exposure to environmental pollutants including CO, O3, NO2 and SO2, the results should be interpreted with caution considering some following issues discussed in this review. Therefore, further studies are required considering well-designed studies in large scales to strengthen the evidence.

Factors Associated with Thoughts of Self-Harm or Suicide among Aboriginal and Torres Strait Islander People Presenting to Urban Primary Care: An Analysis of De-Identified Clinical Data

Suicide amongst Aboriginal and Torres Strait Islander people is a major cause of premature mortality and a significant contributor to the health and life expectancy gap. This study aimed to estimate the prevalence of thoughts of self-harm or suicide in Aboriginal and Torres Strait Islander people attending an urban primary health care service and identify factors associated with these thoughts. Multilevel mixed-effects modified Poisson regression models were employed to analyse three years of data gathered during the annual Aboriginal and Torres Strait Islander health assessments. At their first health assessment, 11.5% (191/1664) of people reported thoughts of suicide or self-harm in the prior two weeks. Having children, participating in sport or community activities or being employed full-time decreased the risk of such thoughts. Conversely, factors relating to social exclusion including homelessness, drug use, unemployment and job insecurity increased the risk of thoughts of self-harm or suicide. Individual clinicians, health services, and policy-makers all have a role in suicide prevention. Clinicians need appropriate training to be able to respond to people expressing these thoughts. Aboriginal and Torres Strait Islander community organisations need sovereignty and self-determination over resources to provide programs that promote cultural connectivity and address social exclusion, thereby saving lives.